Provider Demographics
NPI:1154358513
Name:PARKS, KAREN S (LPC)
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:S
Last Name:PARKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8190
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73522-8190
Mailing Address - Country:US
Mailing Address - Phone:580-482-4095
Mailing Address - Fax:580-481-2499
Practice Address - Street 1:1200 E TAMARACK RD
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-1234
Practice Address - Country:US
Practice Address - Phone:580-482-4095
Practice Address - Fax:580-481-2499
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3496101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health